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Organization

NORTHEASTERN PENNSYLVANIA IMAGING CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JULIANN R. HALL MBA (PRACTICE ADMINISTRATOR)
(570) 346-6633
Entity
Organization

Contact information

Practice address
2601 STAFFORD AVE, SCRANTON, PA 18505-0305
(570) 346-6633
(570) 346-4049
Mailing address
2601 STAFFORD AVE, PO BOX 3305, SCRANTON, PA 18505-0305
(570) 346-6633
(570) 346-4049

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
2085N0700X
Neuroradiology Physician
2085N0904X
Nuclear Radiology Physician
2085P0229X
Pediatric Radiology Physician
2085R0202X
Diagnostic Radiology Physician
Primary
2085U0001X
Diagnostic Ultrasound Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000072505
UNISON
PA
05
0011162430005
PA
01
0032528
AETNA PIN NUMBER
PA
01
053243
FIRST PRIORITY HEALTH
PA
01
1686
GEISINGER HEALTH PLAN
PA
01
20010377
20010377
PA
01
2Y6956
PHS HEALTHNET
PA
01
475385
HIGHMARK BLUE SHIELD
PA
01
999004
BLUE CROSS NE PA
PA
01
CB3186
RAILROAD MEDICARE
PA
Enumeration date
07/27/2006
Last updated
02/29/2012
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